Healthcare Provider Details

I. General information

NPI: 1639970304
Provider Name (Legal Business Name): CHRISTOPHER ADAM ZINKLE MS, CRC, COTA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2025
Last Update Date: 03/20/2025
Certification Date: 03/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 E END BLVD
WILKES BARRE PA
18711-0030
US

IV. Provider business mailing address

1111 E END BLVD
WILKES BARRE PA
18711-0030
US

V. Phone/Fax

Practice location:
  • Phone: 570-824-3521
  • Fax: 570-821-7299
Mailing address:
  • Phone: 570-824-3521
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225C00000X
TaxonomyRehabilitation Counselor
License Number642437
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: